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Rabies

Rabies

3 December 2019

Causative agent

Rabies is an acute infection of the central nervous system caused by the rabies virus. It affects mammals like dogs, cats, foxes, bats and humans.

Mode of transmission

When humans are bitten or scratched, or when their broken skin is licked by an infected animal, the virus in the saliva of the infected animal enters the human body through the wound and travels through nerves to the brain, leading to encephalitis. Rarely, rabies may also be transmitted by inhalation of virus-containing aerosol or via transplantation of an infected organ.

Incubation period

The incubation period is usually 2 to 3 months, but may vary from less than 1 week to over 1 year.

Clinical features

The initial presentation of rabies may be nonspecific and include flu-like symptoms such as malaise, fever or headache, which may last for days. There may be numbness and tingling sensation around the wound. After a few days, anxiety, confusion, spasm of swallowing muscles, paralysis, coma and death will occur.

Management

Once symptoms of rabies appear, the disease is nearly always fatal, and treatment is supportive.

Prevention

  1. Dog owners should make sure their dogs are licensed and vaccinated against rabies.
  2. Avoid contact with stray animals, including dogs, cats and monkeys.
  3. Pre-exposure or post-exposure immunisation, combined with thorough wound cleaning, is the most effective method of preventing rabies. After being bitten by animal, wash wound thoroughly with liquid soap and water immediately. Then seek medical attention at the nearest Accident and Emergency Department. If necessary, post-exposure immunisation may be given by the attending doctor.
  4. Pre-exposure immunisation is recommended when travelling to high-risk destination for long-stay travellers, short-stay travellers to remote rural regions without medical facilities, or travellers with extensive outdoor exposure or engaging in high-risk activities (such as hiking, trekking, cycling, animal handling and visiting bat-infested caves). Please visit the website of Travel Health Service of the Department of Health for more details.

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